PTH and osteoporosis: Primary hyperparathyroidism (PHPT) is an endocrine disorder characterized by hypercalcemia due to the aberrant production of parathyroid hormone (PTH), and although most often, the presentation of PHPT is asymptomatic in the regions of the world where serum levels of calcium are routinely measured, more severe cases PHPT can manifest osteoporosis and hypercalciuria as well as vertebral fractures and nephrolithiasis [78].